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目的评估多排螺旋CT在检测早期胃癌术前淋巴结转移中的临床价值。方法使用多排螺旋CT评估77例早期胃癌患者的淋巴结转移情况,其中24例患者采用的多排螺旋CT层厚为2.5～5.0 mm,53例患者采用的层厚为7.5～10.0 mm。结果多排螺旋CT检测淋巴结转移的准确率为74.0%,而手术评估的准确率为54.5%。采用2.5～5.0 mm层厚的多排螺旋CT对淋巴结转移诊断的敏感度、特异度、阳性预测值和阴性预测值分别为75.0%、65.0%、30.0%和92.9%;采用7.5～10.0 mm层厚的多排螺旋CT对淋巴结转移诊断的敏感度、特异度、阳性预测值和阴性预测值分别为62.5%、82.2%、38.5%和92.5%;而相应手术的评估值分别为45.5%、63.6%、17.2%和87.2%。结论MDCT对淋巴结转移诊断的准确率较高,对早期胃癌淋巴结转移的检测有一定的临床价值。
Objective To evaluate the clinical value of multislice spiral CT in the detection of preoperative lymph node metastasis of early gastric cancer. Methods The multi-slice spiral CT was used to evaluate the lymph node metastasis in 77 patients with early gastric cancer. Among them, the thickness of multislice spiral CT was 24-5 in 2.5-5.0 mm, and the thickness of 53 patients was 7.5-10.0 mm. Results The accuracy of multislice CT in detecting lymph node metastasis was 74.0%, while the accuracy of surgical evaluation was 54.5%. The sensitivity, specificity, positive predictive value and negative predictive value of multi-slice spiral CT with layer thickness of 2.5-5.0 mm were 75.0%, 65.0%, 30.0% and 92.9%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of thick MSCT were 62.5%, 82.2%, 38.5% and 92.5% respectively for the diagnosis of lymph node metastasis, while the corresponding evaluation values were 45.5% and 63.6 %, 17.2% and 87.2%. Conclusion The accuracy of MDCT in the diagnosis of lymph node metastasis is high, and it has certain clinical value for the detection of lymph node metastasis in early gastric cancer.